From a study of 9 personal cases and of 41 cases from the literature the authors conclude that in many cases of tetanus there are changes in the spinal column (dorsal kyphosis, scoliosis or forward projection of the sternum). These can be found by means of the roentgenogram and occasionally by inspection. Such changes, they report, existed in from 20 to 100 per cent of the cases studied (in their own series, in 60 per cent). The greatest frequency is that in boys from 10 to 15 years of age. The authors believe that the condition is the result of intense muscular traction that produces trabecular fracture at the point of greatest strain. The process is benign and self limiting.

The plates in the book are well chosen, and the authors' arguments are interesting and convincing.